陳冠廷、姜宜妮、張宏江、張奕凱

台灣大學附設醫院 泌尿部

Kuan-Ting Chen, I-Ni Chiang, Hong-Chiang Chang, Yi-Kai Chang

Department of Urology, National Taiwan University Hospital

 

Purpose: We examined whether physical characteristics correlate with disease severity or may influence the fertility outcome after varicocelectomy.

 

Materials and Methods: Adult patients (age ≥ 18) underwent varicocelectomy by two andrology subspecialist physicians in our hospital during the past ten years were enrolled. Physical characteristics data included height, body weight, sonographic testicular volume and varicocele grading were collected through chart review. Fertility outcome was determined by differences of semen parameter before and after varicocelectomy.

 

Results: Totally 172 men receiving varicocelectomy were enrolled from February 2006 to August 2017. Among these patients, average height was 172.5 ± 5.7 cm, and average body weight was 68.0 ± 9.1 Kg. Taller patients tend to have more severe varicoceles, and height among these patients was independently correlated with disease severity. (Grade 2 vs. Grade 3: 170.1 ± 5.24 cm vs. 172.9 ± 5.09 cm, p = 0.03, HR = 0.88(0.78-0.99), p = 0.03) Varicocelectomy significantly improved semen parameters in both Oligoasthenoteratozoospermic(OAT) and azoospermic patients. In subgroup analysis, azoospermic patients with higher body weight before surgery were associated with better fertility outcomes. (Semen improvement vs. no improvement: 74.3 ± 6.8 kg vs. 66.2 ± 6.5 kg, p = 0.04) No correlations between physical characteristics and semen parameter change has been found among normal or OAT patients.

 

Conclusions: In adult males receiving varicocelectomy, taller patients were associated with worse varicocele grading. Higher body weight is associated with better semen parameter outcomes after varicocelectomy among azoospermic patients.